Fractures
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Fractures in children differ from adults and can involve the growth plates. The document discusses the etiology, pathophysiology, types, healing process, clinical presentation, and management of fractures in children. Fractures are typically caused by low velocity trauma and abuse should be suspected in children under age 2. Unique fractures in children include epiphyseal injuries at the growth plates. Therapeutic management focuses on realignment, casting, traction, and immobilization to regain function and prevent further injury.
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Spina bifida is a birth defect where the spinal column does not fully close around the spinal cord. It occurs when the neural tube fails to close properly during early embryonic development. The main types are spina bifida occulta (mildest), meningocele (meninges protrude through opening), and myelomeningocele (most severe where spinal cord and membranes protrude). Symptoms range from minor skin marks to paralysis depending on location and severity of the defect. Treatment involves surgery to cover the exposed tissues and may include shunts to drain excess cerebrospinal fluid. Lifelong management focuses on rehabilitation, prevention of infections and complications, and addressing mobility, bladder, and bowel issues.
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Pyloric stenosis is a narrowing of the opening from the stomach to the small intestine caused by thickening of the pyloric muscle. It typically presents in infants as projectile vomiting after feeding. Diagnosis is usually made clinically based on symptoms and feeling an olive-sized mass in the abdomen. Treatment involves initially stabilizing the infant followed by surgery to cut the thickened pyloric muscle. With timely diagnosis and treatment, prognosis is excellent with complete relief of symptoms and normal development. Nurses play an important role in pre and post-operative care including monitoring temperature, IV fluids, pain, and for any surgical complications.
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Failure to thrive (FTT) refers to inadequate growth in infants and children. It is defined as weight below the 3rd percentile or a significant decrease from an established growth curve. FTT can be organic, due to medical causes like prematurity or malnutrition, inorganic, due to non-medical causes like neglect or poor parenting, or mixed. Clinical features include low weight and height compared to standards, as well as decreased developmental milestones. Diagnosis involves medical history, physical exam, and tests to identify underlying causes. Management focuses on optimizing nutrition, providing a nurturing environment, parental education, and treating any medical issues contributing to FTT.
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- Surgical release of soft tissues may be needed for resistant cases. Post-operatively, bracing is used to maintain correction.
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7. Dislocation of elbow and other fractures near elbow
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Fractures
- 1. GOOD MORNING
- 2. FRACTURES
- 3. FRACTURES A fracture is a break or disruption in the continuity of the bone.Fractures in children differ from those in adults
- 4. FRACTURES ETIOLOGY • Most fractures in children are as a result of low velocity trauma such as a fall • Upto age 2,most fractures are sustained as a result of child abuse. Abuse should be suspected in this age group • Fractures in newborns and often the result of child abuse
- 5. FRACTURES PATHOPHYSIOLOGY A bone fractures when the force applied to it exceeds the amount the bone can absorb. • Children’s long bone are almost resilent then those of adults.they are able to withstand greater deflection without fracturing • Children’s long bone also have thick periosteum
- 6. FRACTURES • Unique to fractures in children is the involvement of growth plates.The plate is weaker than the surrounding ligaments and tendons and joint capsules and is disrupted before these tissues are injured. • Epiphyseal or physeal injuries • The weakest point of long bones is the cartilage growth or epiphyseal plate.
- 7. FRACTURES • Types of fracture • Complete( Bone fragments are separated) • Incomplete( fragments remain attached •
- 8. FRACTURES The fracture line can be any of the following • Transverse- cross wise at right angle to the long axis of the bone • Oblique- slanting but straight between a horizontal and a perpendicular direction • Spiral- slanting or circular, twisting around the bone shaft
- 11. FRACTURES • Simple or closed fracture • Open or compound fracture • Complicated fracture • Communited fracture
- 13. FRACTURES TYPES OF FRACTURE IN CHILDREN • Bend (bent 45 degrees n more.mostly ulna and fibula) • Buckle or torus (compression of porus bone raised or bulging projection) • Green stick fracture (occurs when a bon eis angulated beyond the limits of bending)
- 15. FRACTURES • BONE HEALING AND REMODELLING • Neonatal period 2 to 3 weeks • Early childhood- 4 weeks • Later childhood- 6 to 8 weeks • Adolescence- 8 to 12 weeks
- 16. FRACTURES • Clinical manifestations Generalized swelling,pain or tenderness,deformity,diminishe d functional use of affected part • Diagnostic evaluation- history and radiographic examination
- 17. FRACTURES Therapeutic management Goal • To regain allignment and length of the body fragments • To retain allignment and length • To restore function to the injured parts to prevent further injury
- 18. FRACTURES • Therapeutic management • Realignment by traction • Closed manipulation • Casting • Weight bearing on lower extremities
- 19. FRACTURES • Nursing considerations • Initial assessment • Reassuring the parent and the child • Reduction of pain • Care of child in a cast • Care of child in a traction
- 20. FRACTURES Nursing alerts • Pain • Pallor • Pulselessness • Paresthesia • paralysis
- 21. The child in a cast Four major categories • Upper extremeties • to immobilise wrist or elbow • Lower extremity • to immobilise ankle or knee • Spinal or cervical • immobilisation of the spine • Spica casts to immobilise the hip and knee
- 26. Spinal or cervical cast
- 27. Spica casts
- 34. Sunthetic cats
- 39. The child in traction Purposes • To provide rest for an extremity • To help prevent or improve contracture deformity • To correct a deformity • To treat a dislocation • To provide poistioning and allignment • To reduce muscle spasm
- 40. Types of traction Upper extremity traction Overhead suspension traction Dunlop traction Lower extremity traction Bryant traction Buck traction Russel traction Balance suspension traction Cervical traction
- 41. Over head suspension • The arm bent at the elbow is suspended vertically by skin or skeletal attachment and traction is applied to the distal end of the humerus
- 43. DUNLOP TRACTION The arm is suspended horizontally using skin or skeletal attachment
- 45. BRYANT TRACTION It is a type of running traction in which the pull is in only one direction.legs are flexed at 90 degree of the hips
- 46. Bryant traction
- 47. Bucks traction • Type of traction in which the legs are in extended position • Used for short term immobilisation
- 49. Buck’s traction
- 50. Rusell traction • Uses skin traction on the lower leg and a padded sling under the knee.two lines of pull one along the longitudinal line and the other perpensdicular to the leg
- 54. Balance suspension traction • A thomas splint from the groin to above the foot • Pearson attachment to support the lower leg
- 57. Thank you